Productivity and its Drivers in Finnish Primary Care 1988-2003

Maija-Liisa Järviö, Kalevi Luoma, Tarmo Räty and Juho Aaltonen

No 118, Research Reports from VATT Institute for Economic Research

Abstract: We measure productivity changes of primary care in Finland between 1988 and 2003 as a ratio of key services produced and real operating costs. In the second stage we estimate a truncated regression model that quantifies the contribution of certain internal and exogenous factors to productivity. We use newly developed techniques to correct asymptotic bias in non-parametric efficiency scores and bootstrap the confidence intervals for the explanatory model parameter estimates. The bias accounts on average 2.8 percent decrease in efficiency level. From 1997 to 2003 the average productivity declined 13.7 percent; the result is insensitive to estimated bias. Even if standard parametric confidence intervals do not generally apply when efficiency scores are regressed, our bootstrapped intervals are almost equal to parametric ones. Of the correlates used the increased income subject to municipal taxation accounted for three percentage points of the productivity decrease. The correlates, that are expected to decrease the need of primary care services, had a negative impact on productivity, implying that health centres have not been able to adjust their resource usage correspondingly. Organisational changes that have taken place within primary care have not resulted in desired productivity improvements.

Keywords: Primary care, health centres, productivity, bootstrap, Local public economics, Kunnallistalous, Public services, Julkiset palvelut, Effectiveness of public services, Julkisten palvelujen vaikuttavuus, C150 - Statistical Simulation Methods; Monte Carlo Methods; Bootstrap Methods, D610 - Allocative Efficiency; Cost-Benefit Analysis (contingent valuation), I110 - Analysis of Health Care Markets, (search for similar items in EconPapers)
Date: 2005
New Economics Papers: this item is included in nep-eff and nep-hea
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (3)

Downloads: (external link)
https://www.doria.fi/handle/10024/148590

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:fer:resrep:118

Ordering information: This working paper can be ordered from

Access Statistics for this paper

More papers in Research Reports from VATT Institute for Economic Research Contact information at EDIRC.
Bibliographic data for series maintained by Anita Niskanen ().